摘要
目的分析82例剖宫产术后再次妊娠阴道试产(trial of labor after cesarean,TOLAC)产妇的妊娠结局。方法回顾性分析2020年1-12月于福建省医科大学附属三明市第一医院进行TOLAC的82例产妇资料,根据试产结局将其分为TOLAC成功组65例与TOLAC失败组17例。针对两组产妇年龄、学历、孕周、BMI、新生儿体质量、距离上次剖宫产时间、既往阴道分娩史、临产时宫颈评分、有无胎膜早破等情况进行单因素与多因素Logistic回归分析。结果单因素分析显示,TOLAC成功组年龄(30.92±3.46)岁、BMI(25.51±2.63)kg/m^(2)、新生儿体质量(3205.54±35.48)g、临产时宫颈评分(5.89±1.03)分、既往阴道分娩史发生率38.46%与TOLAC失败组(36.35±3.33)岁、BMI(30.21±1.75)kg/m^(2)、新生儿体质量(3773.53±69.37)g、临产时宫颈评分(2.18±1.49)分、既往阴道分娩史发生率11.76%比较,差异有统计学意义(t=5.804、6.959、46.983、11.978,χ^(2)=4.349,P<0.05),两组学历、距离上次剖宫产时间、孕周、有无胎膜早破对比,差异无统计学意义(P>0.05)。多因素Logistics回归分析显示,年龄、BMI、新生儿体质量、临产时宫颈评分是影响TOLAC妊娠结局的危险因素(P<0.05)。结论孕妇年龄、BMI、新生儿体质量、宫颈情况是影响TOLAC妊娠结局的危险因素,临床应予以足够的重视,加强监测与防控措施,以便保障妊娠结局。
Objective To analyze the pregnancy outcomes of 82 women with repeat vaginal trial of labor after cesarean section(TOLAC).Methods The data of 82 women who underwent TOLAC at Sanming First Hospital affiliatied to Fujian Medical University from January to December 2020 were retrospectively analyzed,and they were divided into two groups according to the outcome of the trial of labor,65 cases in the successful TOLAC group and 17 cases in the failed TOLAC group.Univariate and multifactorial Logistic retrospective analysis were performed for maternal age,education,gestational week,BMI,neonatal weight,time since last cesarean delivery,history of previous vaginal delivery,at term cervical score,and presence of premature rupture of membranes in both groups.Results Univariate analysis showed that age(30.92±3.46)years,BMI(25.51±2.63)kg/m^(2),neonatal weight(3205.54±35.48)g,cervical score at delivery(5.89±1.03)points,history of previous vaginal delivery 38.46%in the successful TOLAC group were different from those in the failed TOLAC group(36.35±3.33)years,BMI(30.21±1.75)kg/m^(2),neonatal weight(3773.53±69.37)g,cervical score at delivery(2.18±1.49)points,history of previous vaginal delivery 11.76%,the difference was statistically significant(t=5.804,6.959,46.983,11.978,χ^(2)=4.349,P<0.05),and there was no statistically significant difference between the two groups in the comparison of education,time since last cesarean delivery,gestational week,and presence of premature rupture of membranes(P>0.05).Multifactorial Logistic regression analysis showed that age,BMI,neonatal weight,and cervical score were risk factors for pregnancy outcome in TOLAC(P<0.05).Conclusion Maternal age,BMI,neonatal weight,and cervical condition are risk factors affecting pregnancy outcome in TOLAC,and should be given sufficient clinical attention to strengthen monitoring and preventive and control measures in order to safeguard pregnancy outcome.
作者
姚燕华
姚敏蓉
赵勇
YAO Yanhua;YAO Minrong;ZHAO Yong(Department of Obstetrics,Sanming First Hospital affiliatied to Fujian Medical University,Sanming,Fujian Province,365000 China)
出处
《中外医疗》
2022年第33期87-91,共5页
China & Foreign Medical Treatment
关键词
剖宫产术
再次阴道分娩
妊娠结局
Caesarean section
Repeat vaginal delivery
Pregnancy outcome
